Status Insurance Brokers

Client Details

* Client First Name

* Client Last Name

* Client Email

Client SMS Number

Client Landline Number (if applicable)

Information Request Contact

Who is the best person to contact if MCGQS Staff need to ask any further questions or require any additional info relating to this Job?

Please ensure the Insurance Broker details are entered in the appropriate fields later in the form.

* Info Contact First Name

Info Contact Last Name

* Info Contact Email

Info Contact Mobile Number

Info Contact Landline Number

Property Information

* Address 1

* Suburb/Town

Address 2

* Postal Code

* Country

Please note that a Comprehensive report is required if individual costs need to be provided for multiple buildings.

Sum Insured on Existing Policy

Relevant Information / Details

Insurance Broker Details

Broker First Name

Broker Last Name

Broker Email

Broker SMS Number

Broker Landline Number

Terms and Conditions

* I agree to the Terms and Conditions

Quoted Price

Submit Booking

Our team will review your booking and contact you within the next business day with confirmation.

For any additional documents you wish to add, email directly to contact@mcgqs.com.au with the property address in the subject line.

Insurance Assessment Booking Form